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DIAGNOSIS

I was diagnosed with lupus of the skin because of the result of 2 biopsy's. However all of my bloodwork is normal. If my bloodwork is normal then how do I have all kinds of symptoms? I am exhaused all of the time, my hand and feet have pins and needles all of the time.Im being treated for dry eyes. I have lots of water retention and joint pain. And i have a rash on my toes. Can anyone tell me iif it is possible to have systemic lupus without it showing up in the bloodwork?

Systemic lupus is a difficult to diagnose because it is a disease that does not typically develop rapidly, but rather develops slowly and evolves over time. Symptoms come and go and it generally takes time to gradually accumulate enough symptoms to indicate that a multi-system disease is present. Because many symptoms of systemic lupus erythematosus (SLE) mimic those of other illnesses, lupus can be a difficult disease to diagnose. Diagnosis is usually made by a careful review of three factors:
* Your entire medical history
* an analysis of the results obtained in routine laboratory tests and
* some specialized tests related to immune status.
to be diagnosed with Lupus, you must show clinical evidence of a multi-system disease (i.e. has shown abnormalities in several different organ systems). If you have several of these symptoms, your doctor will then usually order a series of tests to examine how well your immune system is functioning. In general, he is looking for evidence of auto-antibodies. Although there is no one test that can definitely say whether or not you have lupus, there are many laboratory tests which help your doctor to make a lupus diagnosis.
The commonly used lab tests are:
* Anti-nuclear antibody test (ANA) to determine if autoantibodies to cell nuclei are present in the blood
* Anti-DNA antibody test to determine if there are antibodies to the genetic material in the cell
* Anti-Sm antibody test to determine if there are antibodies to Sm, which is a ribonucleoprotein found in the cell nucleus
* Serum (blood) complement test to examine the total level of a group of proteins which can be consumed in immune reactions
* Complement proteins C3 and C4 test to examine specific levels
A negative ANA test is strong evidence against lupus as the cause of a person's illness, although there are very infrequent instances where SLE is present without detectable antinuclear antibodies. ANA-negative lupus can be found in people who have anti-Ro (SSA) or antiphospholipid antibodies.
The interpretation of all these tests, and their relationship to symptoms, can be very difficult. When a person has many symptoms and signs of lupus and has positive tests for lupus, it is easier for doctors to make a correct diagnosis and begin treatment. However, it is quite common for an individual to report symptoms of achy joints, fever, fatigue, or pain, skin rashes, and to have negative or borderline test results. Even so, with growing awareness of SLE, an increasing number of doctors will consider the possibility of lupus in the diagnosis even with negative and/or borderline tests.
I hope this has been helpful and not confused you more :?